Annals of family medicine
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Annals of family medicine · Apr 2022
Using the cardiovascular risk profile in a community heart health outreach intervention: Implications for primary care.
Context: "HeartB," a community heart health intervention and academic partnership, focused on urban African African urban at high risk for heart disease, was implemented by community health workers (CHW) and a community nurse. Objective: The primary objective was to reduce heart disease risk in Detroit by increasing participants' knowledge of heart disease, with a secondary objective of facilitating prevention of developing heart disease by increasing understanding of how to lower risks for heart disease. Study Design and Analysis: Quasi-experimental (pre-post) design and six-month follow-up. ⋯ Following collection of family history information, participants met with the project nurse and CHW for clinical assessments, (weight, BP and medical history) and to discuss their cardiovascular risk factors. Based on the clinical assessment and medical history, the Framingham Heart Study Risk Assessment non-lab tool (D'Agostino, 2007) was used to provide the participants with their heart age and CVD risk for developing heart disease in the next ten years. 54% had <10% probability of a CVD event in the next 10 years, 26% had between a 10-19% probability, and 20% had a 20%/greater probability. Conclusions: Primary care physicians should be encouraged to work with CHW in African American communities to conduct long-term interventions to determine effective strategies for cardiovascular risk reduction.
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Annals of family medicine · Apr 2022
Does de-implementation of low value care impact the patient-clinician relationship? A mixed methods study.
Context: In the U. S., provision of LVC is prevalent (up to 20% of total health services), costly ($350 billion annually), and associated with patient harm. Concern about a negative impact on the patient-clinician relationship has been cited by primary care clinicians as a barrier to reducing LVC. ⋯ However, most emphasized that negative impacts could be mitigated if the clinician listened to them, spent time with them, and offered understandable advice. Conclusions: Findings emphasize prioritization of the patient-clinician relationship in LVC de-implementation interventions and suggest minimal impact of such interventions on the patient-clinician relationship. Evidence of service-specific differences was observed.
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Annals of family medicine · Apr 2022
The potential of folate derivatives and Hantzsch esters to inhibit ultraviolet-induced reactive oxygen species.
Context: Ultraviolet (UV) radiation causes 60,000 premature deaths worldwide per year. In the US alone, UV-associated skin cancers cost over $8 billion annually. UV radiation causes harm primarily through inducing carcinogenic reactive oxygen species (ROS). ⋯ Several Hantzsch esters demonstrate energy favorability in inhibiting ROS in silico. Conclusions: Folate derivatives and their chemical analogs, Hantzsch esters, offer a method of inhibiting ROS induced by ultraviolet radiation, and hence, a potential method for reducing the tremendous health burden of ultraviolet radiation. Further study is needed to determine the extent to which this ROS inhibition decreased carcinogenesis.
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Annals of family medicine · Apr 2022
"We want to be heard": Perspectives on mental health care among patients at a federally qualified health center.
Depression is a debilitating condition associated with significant medical, social, and economic costs for individuals and communities. Despite its widespread prevalence, depression is typically under-identified and under-treated, particularly for people of color and lower socioeconomic status. Primary care settings such as federally qualified health centers (FQHCs) offer an ideal opportunity to rectify this gap for underserved communities. ⋯ The identified factors cast light on opportunities at multiple levels for community-based outpatient clinics to better support patients with mental health needs, and ultimately narrow persistent gaps in access.
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Annals of family medicine · Apr 2022
Understanding culturally tailored approaches in males of punjabi ancestry with alcohol use disorder at Roshni Clinic.
1. Identify and describe factors that are important to the care of patients of Punjabi ancestry suffering from AUD. 2. Explain the importance of culturally tailored approaches to primary care in the context of AUD. ⋯ Culturally tailored approaches and providers fluent in the Punjabi language proved to be the most beneficial factors to patients at Roshni Clinic. There are limited culturally tailored, primary care addictions centers such as Roshni Clinic serving Punjabi males with AUD in BC's Lower Mainland. Thus, this study stresses the importance of investment in research and development of patient informed culturally tailored care centers.